Average glandular dose for contrast-enhanced mammography examinations (CEM): a comparison between two centers

Contrast-enhanced mammography (CEM) is increasingly being implemented in clinical settings as a valuable technique for cancer detection. Doses delivered during CEM examinations are the major concern. Doses are due to the low (LE) and high (HE) energy exposures required. This study is focused on comparing the average glandular doses (AGD) delivered to patients in CEM examinations performed in two centers that are equipped with an x-ray system of the same vendor. Data on 32 and 67 patients were retrospectively collected in center 1 (C1) and center 2 (C2). Most of the enrolled patients are recalled after a suspicious lesion was detected during breast screening. In both centers, mean age was 58y and mean compressed breast thickness was 60mm. AGD values were calculated following the European and IAEA protocol for LE and HE exposures which were summed to obtain the per-view AGD for the CEM. Per-patient AGD was computed for each center and for the pooled dataset. Per view AGD-LE exposures do not exceed the acceptable values proposed in the European protocol. LE(HE) contribution to the per patient AGD-CEM is 68% (32%) for CBTs<50 mm and 80% (20%) for CBTs≥50 mm. Median per patient AGD values at C1 and C2 for a bilateral CEM examination were 4.73mGy and 5.64mGy. This value is 5.51mGy for the pooled dataset.